title: Recurrent transient hemiparesis in a patient with a giant persisting Eustachian valve and patent foramen ovale: atypical hemiplegic migraine or paradoxical cerebral embolism?
abstract: We encountered a patient with the overlapping disorders of migraine with aura, migraine-triggered seizures and recurrent transient hemiparesis caused by atypical hemiplegic migraines with motor weakness during headache attacks, but not during the aura period, or paradoxical cerebral embolism. The patient displayed a giant Eustachian valve and patent foramen ovale, through which a spontaneous right-to-left shunt was revealed on transesophageal echocardiography. We considered that the overlapping disorders in the present case were closely related to the spontaneous right-to-left shunt caused by the giant Eustachian valve.
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, Japan. yujik@saitama-med.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kato
authors.forename: Takuya
authors.initials: T
authors.lastname: Fukuoka
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Dembo
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Takeda
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
mesh_terms: D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications / Q000175:diagnosis*; D006351:Heart Valves / Q000002:abnormalities* / Q000473:pathology*; D006801:Humans; D020766:Intracranial Embolism / Q000150:complications / Q000175:diagnosis*; D020325:Migraine with Aura / Q000150:complications / Q000175:diagnosis*; D010291:Paresis / Q000150:complications / Q000175:diagnosis*; D012008:Recurrence; D055815:Young Adult